Disease Prevention in Women (cont.)

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Bladder cancer

Screening tests

Urine examination for blood cells (urinalysis). This may be done by dipstick with confirmation by microscopic examination of the urine, or by initial microscopic examination.

Bladder cancer can cause either gross hematuria (visible blood in the urine) or microscopic hematuria (blood in the urine only visible with a microscope).

(Note that bladder cancer is only one of many causes of blood in the urine.)

Who to test and how often

All people who are current or former cigarette smokers or who have a history of occupational exposure to certain chemicals often used in the dye, leather, tire, and rubber industries should have a urine examination for blood periodically after the age of 60 years.

Benefits of early detection

Early bladder cancer may produce no symptoms and no visible bleeding in the urine, and blood in the urine is most commonly microscopically apparent and not seen by the naked eye.

Treatment can be effective if the cancer is detected early, and survival is strongly associated with stage of disease at time of treatment.

Cessation of cigarette smoking is always advisable.

Glaucoma

Glaucoma is a condition with abnormally elevated intra-ocular pressures (pressure within the eyes).

Screening tests

Measurement of intra-ocular pressure should be a standard component of a comprehensive eye examination.

Note that a check up for vision does not measure intra-ocular pressure.

Who to test and how often

The American Academy of Ophthalmology's recommended intervals for eye exams, including glaucoma screening, are:

Age 20-29: Individuals of African descent or with a family history of glaucoma should have an eye examination every three to five years. Others should have an eye exam at least once during this period.

Age 30-39: Individuals of African descent or with a family history of glaucoma should have an eye examination every two to four years. Others should have an eye exam at least twice during this period.

Age 40-64: Every two to four years.

Age 65 or older: Every one to two years.

Although there is no formal screening recommendation for healthy subjects with normal risk, everybody over 60 years of age should have intra-ocular pressure measurements periodically, perhaps yearly.

Benefits of early detection

Glaucoma causes extensive damage to the retina and irreversible loss of vision without warning symptoms and before the individual becomes aware of loss of vision.

There is good evidence that treatment of elevated eye pressure in glaucoma can prevent blindness.